Roman Huber

Publications (37) View all

• Article: Body Fat Distribution as a Risk Factor for Cerebrovascular Disease: An MRI-Based Body Fat Quantification Study.

  Hanna-Sofia Karcher, Robert Holzwarth, Hans-Peter Mueller, Albert C Ludolph, Roman Huber, Jan Kassubek, Elmar H Pinkhardt
  [show abstract] [hide abstract]
  ABSTRACT: Background: While adiposity is a well-established risk factor for cardiovascular disease, the association between adiposity and cerebrovascular disease is not entirely understood. For example, common methods to quantify body fat volume such as body mass index, waist circumference and waist-to-hip ratio are not suitable to identify the complex distribution patterns of body fat and its relation to cerebrovascular pathology. In view of a better understanding of the association between fat distribution and cerebrovascular disorders, the aim of the study was to perform measurements of body fat distribution patterns and body fat volumes in correlation to arteriosclerosis of the brain-feeding arteries and white matter lesion load (WMLL). Methods: In this study we performed a magnetic resonance imaging (MRI)-based volumetric differential analysis of subcutaneous and visceral body fat distribution in 25 patients with MRI-proven hyperacute ischemic stroke. For the measurement of adipose tissue volume and tissue distribution automatic labeling analysis software was used. A correlation analysis of MRI volumetric measurements of subcutaneous and visceral body fat, atherosclerotic plaque load of the brain-feeding arteries measured by computed tomography angiography, and WMLL measured by MRI volumetry of the whole brain was performed. Results: The normalized total abdominal adipose tissue and the normalized subcutaneous abdominal adipose tissue showed no significant correlation with either WMLL or total plaque volume. In contrast, the normalized visceral adipose tissue showed a significant correlation with WMLL volume. Visceral adipose tissue as a percentage of total adipose tissue showed a significant correlation with WMLL. In particular, the percentage of visceral adipose tissue rather than total body fat volume strongly correlated with atherosclerosis and ischemic cerebral lesions. Furthermore, the volume of both soft and calcified plaques correlated significantly with WMLL. Conclusions: Our results contribute to existing studies about the association of different patterns of fat distribution with atherosclerosis of the brain-feeding arteries, in particular highlighting the importance of visceral adiposity as a risk factor for cerebrovascular disease. The percentage of visceral adipose tissue in total adipose tissue has the potential of a sensitive parameter and might become a relevant new epidemiological marker, showing highly significant correlations with well-established markers of cerebrovascular disease. In conclusion, the percentage of visceral adipose tissue by itself has to be regarded as a risk factor for both small vessel cerebrovascular disease and cerebral atherosclerosis of the large-to-medium-sized arteries.
  Cerebrovascular Diseases 04/2013; 35(4):341-348. · 2.72 Impact Factor
• Article: Acute Cerebrovascular Disease in the Young: The Stroke in Young Fabry Patients Study.

  Arndt Rolfs, Franz Fazekas, Ulrike Grittner, Martin Dichgans, Peter Martus, Martin Holzhausen, Tobias Böttcher, Peter U Heuschmann, Turgut Tatlisumak, Christian Tanislav, [......], Michael G Hennerici, Manfred Kaps, Christof Kessler, Karl Lackner, Eduard Paschke, Wolfgang Meyer, Hermann Mascher, Olaf Riess, Edwin Kolodny, Bo Norrving
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND AND PURPOSE: Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. METHODS: Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol. RESULTS: Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%-0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18-24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%). CONCLUSIONS: Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies.Clinical Trial Registration Information-clinicaltrial.gov identifier: NCT00414583.
  Stroke 01/2013; · 5.73 Impact Factor
• Article: Lifestyle Risk Factors for Ischemic Stroke and Transient Ischemic Attack in Young Adults in the Stroke in Young Fabry Patients Study.

  Bettina von Sarnowski, Jukka Putaala, Ulrike Grittner, Beate Gaertner, Ulf Schminke, Sami Curtze, Roman Huber, Christian Tanislav, Christoph Lichy, Vida Demarin, [......], Franz Fazekas, Peter M Rothwell, Martin Dichgans, Gerhard J Jungehulsing, Peter U Heuschmann, Manfred Kaps, Bo Norrving, Arndt Rolfs, Christof Kessler, Turgut Tatlisumak
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND AND PURPOSE: Although many stroke patients are young or middle-aged, risk factor profiles in these age groups are poorly understood. METHODS: The Stroke in Young Fabry Patients (sifap1) study prospectively recruited a large multinational European cohort of patients with cerebrovascular events aged 18 to 55 years to establish their prevalence of Fabry disease. In a secondary analysis of patients with ischemic stroke or transient ischemic attack, we studied age- and sex-specific prevalences of various risk factors. RESULTS: Among 4467 patients (median age, 47 years; interquartile range, 40-51), the most frequent well-documented and modifiable risk factors were smoking (55.5%), physical inactivity (48.2%), arterial hypertension (46.6%), dyslipidemia (34.9%), and obesity (22.3%). Modifiable less well-documented or potentially modifiable risk factors like high-risk alcohol consumption (33.0%) and short sleep duration (20.6%) were more frequent in men, and migraine (26.5%) was more frequent in women. Women were more often physically inactive, most pronouncedly at ages <35 years (18-24: 38.2%; 25-34: 51.7%), and had high proportions of abdominal obesity at age 25 years or older (74%). Physical inactivity, arterial hypertension, dyslipidemia, obesity, and diabetes mellitus increased with age. CONCLUSIONS: In this large European cohort of young patients with acute ischemic cerebrovascular events, modifiable risk factors were highly prevalent, particularly in men and older patients. These data emphasize the need for vigorous primary and secondary prevention measures already in young populations targeting modifiable lifestyle vascular risk factors.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00414583.
  Stroke 11/2012; · 5.73 Impact Factor
• Article: Antibody-Mediated Status Epilepticus: A Retrospective Multicenter Survey.

  Franz Josef Holzer, Andrea O Rossetti, Anne-Chantal Heritier-Barras, Dominik Zumsteg, Robert Roebling, Roman Huber, Holger Lerche, Ines C Kiphuth, Jürgen Bardutzky, Christian G Bien, Mathias Tröger, Gaby Schoch, Harald Prüss, Margitta Seeck
  [show abstract] [hide abstract]
  ABSTRACT: Background: In recent years, an increasing number of auto-antibodies (AB) have been detected in the CSF and serum of patients with new onset epilepsy. Some of these patients develop convulsive or nonconvulsive status epilepticus (AB-SE), necessitating intensive medical care and administration of multiple antiepileptic and immunomodulatory treatments of uncertain effectiveness. Objectives: In this retrospective multicenter survey we aimed to determine the spectrum of gravity, the duration and the prognosis of the disorder. In addition, we sought to identify the antibodies associated with this condition, as well as determine whether there is a most effective treatment regime. Methods: 12 European Neurology University Clinics, with extensive experience in the treatment of SE patients, were sent a detailed questionnaire regarding symptoms and treatment of AB-SE patients. Seven centers responded positively, providing a total of 13 patients above the age of 16. Results: AB-SE affects mainly women (12/13, 92%) with a variable age at onset (17-69 years, median: 25 years). The duration of the disease is also variable (10 days to 12 years, median: 2 months). Only the 3 oldest patients died (55-69 years). Most patients were diagnosed with anti NMDAR encephalitis (8/13) and had oligoclonal bands in the CSF (9/13). No specific treatment regimen (antiepileptic, immunomodulatory) was found to be clearly superior. Most of the surviving 10 patients (77%) recovered completely or nearly so within 2 years of index poststatus. Conclusion: AB-SE is a severe but potentially reversible condition. Long duration does not seem to imply fatal outcome; however, age older than 50 years at time of onset appears to be a risk factor for death. There was no evidence for an optimal antiepileptic or immunomodulatory treatment. A prospective multicenter study is warranted in order to stratify the optimal treatment algorithm, determine clear risk factors of unfavorable outcome and long-term prognosis.
  European Neurology 10/2012; 68(5):310-317. · 1.81 Impact Factor
• Article: Long-term mortality and risk of stroke after transient ischemic attack

  Christian Weimar, Jens Benemann, Roman Huber, Thomas Mieck, Stephen Kaendler, Steven Grieshammer, Zaza Katsarava, Hans-Christoph Diener, on behalf of the German Stroke Study Collaboration
  [show abstract] [hide abstract]
  ABSTRACT: Background Stroke and mortality rates in patients with transient ischemic attack (TIA) differ widely between community-based studies and research cohorts. Our aim therefore was to provide a reliable estimate for TIA patients treated in German neurology departments with an acute stroke unit. Methods A total of 1951 consecutively admitted TIA patients were prospectively documented in 13 centers and 1480 (75.9 %) gave consent for long-term follow-up. During a mean follow-up of 23.4 months, we assessed recurrent cerebrovascular events and cause of death in 1448 patients via standardized telephone interview including confirmation of endpoint events by the treating physician. Results Overall 94 patients (6.5 %) suffered a stroke and 118 patients (8.1 %) died, 21 due to stroke. The Kaplan-Meier estimate for stroke during the first year was 4.4 % (95 % CI 3.2–5.6 %) which corresponds to a relative risk of 9.5 (95 % CI 7.4–12.3) compared to the population-based stroke incidence in Germany. The annual rates after the first year were 2.2 % (95 % CI 1.7–2.7 %) for stroke and 3.2 % (95 % CI 2.7–3.8 %) for death. Independent predictors for stroke during follow-up were age and previous cerebrovascular events. The ABCD2 score did not provide any meaningful prediction of stroke risk at 90 days. Conclusion While the in-hospital risk of stroke was low, long-term stroke rates in our well-defined multicenter hospital-based cohort were comparable to a large randomized trial. In patients with a well-established diagnosis of TIA, only age and previous cerebrovascular events seem to constitute independent predictors for stroke during long-term follow-up.
  Journal of Neurology 04/2012; 256(4):639-644. · 3.47 Impact Factor